QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection
BackgroundQT interval prolongation is common in critically ill patients and is associated with increased mortality. However, the predictive value of a prolonged corrected QT interval (QTc) for myocardial injury and long-term mortality among patients hospitalized with COVID-19 infection is not well k...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-06-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.869089/full |
| _version_ | 1818238697717366784 |
|---|---|
| author | Ariel Banai Yishay Szekely Lior Lupu Ariel Borohovitz Erez Levi Eihab Ghantous Philippe Taieb Aviram Hochstadt Shmuel Banai Yan Topilsky Ehud Chorin |
| author_facet | Ariel Banai Yishay Szekely Lior Lupu Ariel Borohovitz Erez Levi Eihab Ghantous Philippe Taieb Aviram Hochstadt Shmuel Banai Yan Topilsky Ehud Chorin |
| author_sort | Ariel Banai |
| collection | DOAJ |
| description | BackgroundQT interval prolongation is common in critically ill patients and is associated with increased mortality. However, the predictive value of a prolonged corrected QT interval (QTc) for myocardial injury and long-term mortality among patients hospitalized with COVID-19 infection is not well known.PurposeTo evaluate the association of prolonged QTc with myocardial injury and with 1-year mortality among patients hospitalized with COVID-19 infection.Materials and MethodsA total of 335 consecutive patients hospitalized with COVID-19 infection were prospectively studied. All patients underwent a comprehensive echocardiographic evaluation within 48 h from admission. Using the Bazett formula, the QTc interval was calculated from the first ECG tracing recorded at the ER. QTc ≥ 440 ms in males and ≥450 ms in females was considered prolonged. Patients with elevated cardiac biomarkers and/or echocardiographic signs of myocardial dysfunction were considered to have myocardial injury. The predictive value of QTc prolongation for myocardial injury was calculated using a multivariate binary regression model. One-year mortality rate of patients with and without QTc prolongation was compared using the log-rank test, and a multivariate Cox regression model adjusting for multiple covariates was performed to evaluate the 1-year mortality risk.ResultsOne-hundred and nine (32.5%) patients had a prolonged QTc. Compared to patients without QTc prolongation, patients with prolonged QTc were older (70 ± 14.4 vs. 62.7 ± 16.6, p < 0.001), had more comorbidities, and presented with a more severe disease. Prolonged QTc was an independent predictor for severe or critical disease (adjusted HR 2.14, 95% CI 1.3–3.5; p = 0.002) and myocardial injury (adjusted HR 2.07, 95% CI 1.22–3.5; p = 0.007). One-year mortality of patients with prolonged QTc was higher than those with no QTc prolongation (40.4% vs. 15.5; p < 0.001). Following adjustment to multiple covariates including myocardial injury and disease severity, QTc prolongation was found to be associated with increased 1-year mortality risk (HR 1.69, 95% CI 1.06–2.68, p = 0.027).ConclusionProlonged QTc is associated with disease severity, myocardial injury and 1-year mortality among patients hospitalized with COVID-19 infection. |
| first_indexed | 2024-12-12T12:45:47Z |
| format | Article |
| id | doaj.art-b424126baffe413194a7c4c4fabf10bd |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-12T12:45:47Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-b424126baffe413194a7c4c4fabf10bd2022-12-22T00:24:07ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-06-01910.3389/fcvm.2022.869089869089QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 InfectionAriel BanaiYishay SzekelyLior LupuAriel BorohovitzErez LeviEihab GhantousPhilippe TaiebAviram HochstadtShmuel BanaiYan TopilskyEhud ChorinBackgroundQT interval prolongation is common in critically ill patients and is associated with increased mortality. However, the predictive value of a prolonged corrected QT interval (QTc) for myocardial injury and long-term mortality among patients hospitalized with COVID-19 infection is not well known.PurposeTo evaluate the association of prolonged QTc with myocardial injury and with 1-year mortality among patients hospitalized with COVID-19 infection.Materials and MethodsA total of 335 consecutive patients hospitalized with COVID-19 infection were prospectively studied. All patients underwent a comprehensive echocardiographic evaluation within 48 h from admission. Using the Bazett formula, the QTc interval was calculated from the first ECG tracing recorded at the ER. QTc ≥ 440 ms in males and ≥450 ms in females was considered prolonged. Patients with elevated cardiac biomarkers and/or echocardiographic signs of myocardial dysfunction were considered to have myocardial injury. The predictive value of QTc prolongation for myocardial injury was calculated using a multivariate binary regression model. One-year mortality rate of patients with and without QTc prolongation was compared using the log-rank test, and a multivariate Cox regression model adjusting for multiple covariates was performed to evaluate the 1-year mortality risk.ResultsOne-hundred and nine (32.5%) patients had a prolonged QTc. Compared to patients without QTc prolongation, patients with prolonged QTc were older (70 ± 14.4 vs. 62.7 ± 16.6, p < 0.001), had more comorbidities, and presented with a more severe disease. Prolonged QTc was an independent predictor for severe or critical disease (adjusted HR 2.14, 95% CI 1.3–3.5; p = 0.002) and myocardial injury (adjusted HR 2.07, 95% CI 1.22–3.5; p = 0.007). One-year mortality of patients with prolonged QTc was higher than those with no QTc prolongation (40.4% vs. 15.5; p < 0.001). Following adjustment to multiple covariates including myocardial injury and disease severity, QTc prolongation was found to be associated with increased 1-year mortality risk (HR 1.69, 95% CI 1.06–2.68, p = 0.027).ConclusionProlonged QTc is associated with disease severity, myocardial injury and 1-year mortality among patients hospitalized with COVID-19 infection.https://www.frontiersin.org/articles/10.3389/fcvm.2022.869089/fullQTc intervalmortalityCOVID-19myocardial injuryECG |
| spellingShingle | Ariel Banai Yishay Szekely Lior Lupu Ariel Borohovitz Erez Levi Eihab Ghantous Philippe Taieb Aviram Hochstadt Shmuel Banai Yan Topilsky Ehud Chorin QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection Frontiers in Cardiovascular Medicine QTc interval mortality COVID-19 myocardial injury ECG |
| title | QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection |
| title_full | QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection |
| title_fullStr | QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection |
| title_full_unstemmed | QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection |
| title_short | QT Interval Prolongation Is a Novel Predictor of 1-Year Mortality in Patients With COVID-19 Infection |
| title_sort | qt interval prolongation is a novel predictor of 1 year mortality in patients with covid 19 infection |
| topic | QTc interval mortality COVID-19 myocardial injury ECG |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.869089/full |
| work_keys_str_mv | AT arielbanai qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT yishayszekely qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT liorlupu qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT arielborohovitz qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT erezlevi qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT eihabghantous qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT philippetaieb qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT aviramhochstadt qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT shmuelbanai qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT yantopilsky qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection AT ehudchorin qtintervalprolongationisanovelpredictorof1yearmortalityinpatientswithcovid19infection |